| NPI | 1215034277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: KS 0421769) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MO 36432) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2008-06-20 |